{"id":2507,"date":"2009-03-08T12:33:22","date_gmt":"2009-03-08T12:33:22","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/inftss\/"},"modified":"2025-05-14T19:10:23","modified_gmt":"2025-05-14T19:10:23","slug":"inftss","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/inftss\/","title":{"rendered":"Case Definition of Staphylococcal Toxic Shock Syndrome (TSS)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">An illness with the following clinical manifestations:<\/p>\n<ol>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Fever: temperature &gt; 38.9\u00ba C (102\u00ba F)<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Rash: diffuse macular erythroderma<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Desquamation: 1-2 weeks after onset of illness, particularly palms and soles<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hypotension: systolic blood pressure &lt; 90 mm Hg for adults or less than fifth percentile by age for children &lt;16 years of age; orthostatic drop in diastolic blood pressure greater than or equal to 15 mm Hg from lying to sitting, orthostatic syncope, or orthostatic dizziness<\/p>\n<p><!--more--><\/li>\n<\/ol>\n<p>Multisystem involvement: three or more of the following:<\/p>\n<ol>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Gastrointestinal: vomiting or diarrhea at onset of illness<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Muscular: severe myalgia or creatine phosphokinase level at least twice the upper limit of normal for laboratory<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Mucous membrane: vaginal, oropharyngeal, or conjunctival hyperemia<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Renal: blood urea nitrogen or creatinine at least twice the upper limit of normal for laboratory or urinary sediment with pyuria (greater than or equal to 5 leukocytes per high-power field) in the absence of urinary tract infection<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hepatic: total bilirubin, serum glutamic-oxaloacetic transaminase (AST, SGOT), or serum glutamic-pyruvic transaminase (ALT, SGPT) at least twice the upper limit of normal for laboratory<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hematologic: platelets &lt;100,000\/mm3<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Central nervous system: disorientation or alterations in consciousness without focal neurologic signs when fever and hypotension are absent<\/p>\n<\/li>\n<\/ol>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Negative results on the following tests, if obtained:<\/p>\n<ol>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Blood, throat, or cerebrospinal fluid cultures (blood culture may be positive for Staphylococcus aureus)<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Rise in titer to Rocky Mountain spotted fever, leptospirosis, or measles<\/p>\n<\/li>\n<\/ol>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Case classification<\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Probable: a case with five of the six clinical findings described above<\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Confirmed: a case with all six of the clinical findings described above, including desquamation, unless the patient dies before desquamation could occur<\/p>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li>Herzer CM. Toxic shock syndrome: broadening the differential diagnosis. J Am Board Fam Pract. 2001 Mar-Apr;14(2):131-6.<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11314920\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Wharton M, Chorba TL, Vogt RL, Morse DL, Buehler JW. Case definitions for public health surveillance. MMWR Recomm Rep. 1990 Oct 19;39(RR-13):1-43.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/2122225\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Issa NC, Thompson RL. Staphylococcal toxic shock syndrome. Suspicion and prevention are keys to control. Postgrad Med. 2001 Oct;110(4):55-6, 59-62.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11675982\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Feb 23, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[39],"tags":[316,315,314,313,1559,1344,614,5,1558,4,1551,1550,1557],"class_list":["post-2507","post","type-post","status-publish","format-standard","hentry","category-infetious-disease","tag-case","tag-caso","tag-definicion","tag-definition","tag-estafilococico","tag-infectious","tag-shock","tag-sindrome","tag-staphylococcal","tag-syndrome","tag-toxic","tag-toxico","tag-tss"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2507","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2507"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2507\/revisions"}],"predecessor-version":[{"id":9139,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2507\/revisions\/9139"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2507"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2507"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2507"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}